Clone of Way Sports Soccer Registration Form 2025

Way Sports Soccer Registration Form 2026
Athlete Information
Athlete's Name*

First NameLast Name
Birth Date

MonthDayYear
Grade*
Grade athlete will be in Fall 2026
Gender*

MaleFemale
Athlete Size*

Youth XSYouth SYouth MYouth LYouth XLAdult SAdult M

Athlete's Name

First NameLast Name
Birth Date

MonthDayYear
Grade
Grade athlete will be in Fall 2025
Gender

MaleFemale
Athlete Size

Youth XSYouth SYouth MYouth LYouth XLAdult SAdult M

Parent/Guardian Information
Name*

First NameLast Name
E-mail*
example@example.com
Cell Number*
Format: (000) 000-0000.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Emergency Information
Emergency Contact's Name*

First NameLast Name
Relationship*
Phone Number*
Format: (000) 000-0000.
Does the athlete have any allergies, chronic illness, or medical conditions? If yes, please describe.*
Is the athlete prescribed an inhaler? If yes, please explain any instructions.
How did you hear about Way Sports?

FacebookEmailWord of MouthLincolnway Christian ChurchOther
Informed Consent and Acknowledgement

I hereby provide my consent for my child's participation in all activities organized by Way Sports at Lincolnway Christian Church during the chosen program session. By accepting my child's participation, I acknowledge and accept all the potential risks and hazards associated with these activities. I release, exempt, and indemnify Way Sports and all its officials, representatives, and agents from any responsibility for injuries that may occur to my child during their travel to, engagement in, or return from the camp sessions.

If my child sustains an injury, I waive any claims against Way Sports and Lincolnway Christian Church, including its coaches, affiliates, fellow participants, supporting organizations, advertisers, and, if applicable, the owners and landlords of the premises where the event is held. Engaging in sports activities, including soccer, inherently carries a risk of injury, which may include but is not limited to fractures, paralysis, or even fatality.
Medical Release and Authorization

As the legal guardian of the youth athlete listed, I hereby grant permission for qualified and licensed medical professionals to diagnose and administer treatment in the event of a medical emergency. This authorization is applicable when, in the medical professional's judgment, immediate attention is necessary to prevent further harm to the minor child's life, physical appearance, physical functionality, or to alleviate undue pain, suffering, or discomfort should there be a delay in treatment.

I hereby give consent to the attending physician to undertake any necessary medical or minor surgical procedures, and conduct X-ray examinations to the youth athlete named. In cases of a serious illness, the requirement for major surgery, or significant accidental injury, I am aware that the attending physician will make every reasonable effort to contact me as swiftly as possible before proceeding with treatment. This authorization is granted after a reasonable attempt has been made to reach me.

I also authorize the affiliated individuals, including Directors, Coaches, and Team Parents, to provide essential emergency treatment before the child is admitted to a medical facility.

This consent is valid during the dates and for the duration of the registered season. I willingly provide this authorization to ensure prompt medical treatment under emergency circumstances, safeguarding the life and well-being of the named minor child when I am not present.
Signature*

What Programs Are You Registering For? (Limited amount of grants available for families in need. Email matthewpshank@gmail.com to inquire)

Soccer Camp Fee

July 6th-July 9th, 5:00p-6:00p

$50.00 Quantity

Fall Soccer League Registration Fee

Starting August 6th

$110.00 Quantity

Enter coupon

Total

$0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Should be Empty:

Way Sports Soccer Registration Form 2026